1. Technical Field
This disclosure relates to membership enrollment processing in a healthcare service organization. In particular, this disclosure relates to optimization of data entry for member information and enrollment processing in a distributed processing center.
2. Background
Enrollment services for the healthcare industry are labor intensive because the primary function of such services involves inputting member data, where data from a member (enrollee) or the employer of the member must be entered into one or more large computing systems, such as a mainframe computing system. Processing of the member data may also be time consuming, particularly if errors are encountered. Currently, the healthcare industry employs a large number of data entry workers at an enrollment center, often located offshore, to manually handle the data entry tasks. An enrollee or the enrollee's employer typically fills out insurance-related paperwork and documentation, and submits the paperwork to the enrollment center. The enrollment center receives the paperwork as a computer document image (or converts the paperwork to an image document, such as a PDF-type document).
Once the data from the enrollee has been entered into a document, the document is transmitted to the mainframe computing system for batch processing. The mainframe computing system typically processes the batch without regard to any additional processing capability that may be directed to the batch process. Also, unavailability of the mainframe system often limits productivity at the enrollment center, because even though the enrollment center may be capable of operating 24 hours per day, the availability of the mainframe computing system may be limited to specific hours.
Further, when the mainframe computing system is down or otherwise unavailable, the enrollment center operations come to a halt. Additionally, it is very difficult to balance the workload, especially during peak times or seasonal periods, such as the end of the year, when workloads are extremely high.
Accordingly, there is a need for a processing system that permits enrollment center operations to continue during periods of time when the mainframe computing system is not operational, permits optimization of the various batch processes, efficiently distributes processing workloads across geographically separate enrollment centers, increases the efficiency of the enrollment center operation, and improves throughput of healthcare-related enrollment forms.